सदस्य:Dr. rohit pradip keetey

मी Dr. rohit pradip keetey, मराठी विकिपीडियात नवीन सदस्य आहे. मला विकि-मार्गदर्शकांचे मार्गदर्शन आणि मदत हवी आहे!

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धन्यवाद!

माझे सदस्य नाव/टोपण नाव: DR. ROHIT PRADIP KEETEY

Dr. rohit pradip keetey (चर्चा) १०:१५, २५ जानेवारी २०१३ (IST)

cancer

Dr. rohit pradip keetey (चर्चा) १०:२५, २५ जानेवारी २०१३ (IST)DR.ROHIT KEETEY How many different types of cancer are there?

   From one point of view, there are as many types of cancer as there are different   people, because everyone’s genes are different and so no two cancers are exactly alike.
   From another point of view, there are as many different types of human cell – just over 200.

However cancers can be broadly grouped into different types, depending on which tissues they come from.

   Carcinomas the most common types of cancer, arise from the cells known as epithelial cells that cover external and internal body surfaces Lungs , breast and colon are the most frequent cancers of this type
   Sarcomas are cancers arising from cells found in the supporting tissues of the body such as bone, cartilage, fat connective tissue and muscle.
   Lymphomas are cancers that arise in   the lymph nodes and tissues of the body’s immune system.
   Leukemia are cancers of the immature blood cells that grow in the bone marrow and tend to accumulate in large numbers in the blood stream
   Adenomas are tumors that come from glandular tissue like the thyroid the pituitary gland they are often benign.

   types of cancer
   CANCER

WHAT IS CANCER ?

Therearemanydifferenttypesofcellsinthebodyandsomanydifferenttypesofcancerscanarisefromthedifferenttypesofcells.However,unlikenormalcells ,thecancercellsareabnormal&multiplyoutofcontrol. KNOW ABOUT BREAST CANCER To promote awareness on breast cancer encourage early detection and prompt treatment . RISK FACTORS Following are The factors make a woman more prone to get breast cancer. We really can’t prevent breast cancer but what we can do is to detect it early. Early detection saves lives and lowers treatment costs.

    Increasing  age
   A  family  history  of  breast  cancer  especially  if  a  first  degree  relative  (mother  sister  aunt  )  had/has  breast  cancer.
   A  past  history  of  breast  cancer  in  the  other  breast  or  fibrocystic  breast  disease  (an  exaggerated  lumpy  painful  condition  related  to  the  menstrual  cycle.)
   Early  age  of  menarche  ( first  period )
   First pregnancy after 30 years.
   Having no children.
   Women who  have  not  breast  fed  their  children.
   Late  menopause (cessation of periods).
   Dietary  factors  like  consumption  of  alcohol,  drinks/weak  diet,  rich  in  animal  fat  and  obesity.

SIGNS AND SYMPTOMS

A lump or thickening within the breast or armpit.
A discharge from the nipple.
Adiscolourationorchangeinthetextureoftheskinoverlyingthebreast (dimpling/puckering/scaling )

WAYS TO DETECT BREAST CANCER Asmorebreastcancersaredetectedearlyfarfewerwomenwilllosetheirlivesanditispossibletotreatbreastcancerintheearlystageswithpreservationofthebreast. Fortunatelytherearewaysbywhichyoucandetecttheearlyonsetofbreastcancer Breast Self Examination (BSE )This is a simple technique by which every woman above 18-20 years can notice certain changes in her breast which may be suggestive of breast cancer. Ideally it should be performed once a month (preferably a week or so after her periods ) If she has stopped getting periods the examination must be done every month on a fixed day. It should be done in the privacy of her bedroom or whilst bathing when the soapy feel of the body makes it convenient for examination. What follows are instructions and illustrations to help you learn to do BSE.

   Look  at  your  breasts  in  a  mirror.  Look  for  any  changes  in  size  or  shape , retraction  of  nipple  dimpling  or  thickening  of  skin  or  any  obvious  lump.
   Raising  both  your  arms  look  for  any  unevenness  in  your  breasts
   Keep  your  around  your  waist  and  press  them    firmly.  These  positions  may  help  in  showing  any  retraction  or  dimpling  present  over  the  skin  of  the  breast
   Feel  the  whole  breast  in  a  systematic  manner. The  breast  is  divided  into  5  parts.  The  upper  inner  area , upper  outer  area,  lower  inner  area ,lower  outer  area  and  the  central  area  beneath  the   nipple.  Feel  all  the  parts  of  the  breast  without  missing  any  area.
   Lay  down  with  one  of  your  arm  stretched  .  Keeping  your  fingers  close  to  each  other  use  the  flat  surface  of  your  fingers  to  feel  for  any  lump  in  the  breast  Do  not  feel  the  breast  between  the  finger  tips  and  the  thumb.  Press firmly enough to know how  your  breast  feels.  A  firm  ridge  at  your  lower  curve  of  each  breast  is  normal.
    
    
   A  clinical  breast  examination  by  the  doctor

Aspartofyourphysicalcheck-upwithyourgynecologist makesureyourdoctorexaminesyourbreastsatleastonceayearifyoufallwithinoneoftheaboveriskgroups.

   A  mammogram

Thisisessentiallyanx-rayofthebreast. Itisusedonlyforwomenwhofallwithinthehigh-riskgroupandisthereforenotadvocatedforroutineuse.

   If  a  lump  is  present  a  biopsy  may  be  required.

CervicalcancerthemostcommoncanceramongIndianwomen. It isadiseaseinwhichcanceraffectstissuesofthecervixi.e. themouthoropeningofuterus (womb ).125000womenareaffectedeachyearneedlesslyclaiminganestimated50,000lives .Our aimistoalertyouaboutthepreventionandearlydetectionofcervicalcancer.

   Early  onset  of  sexual  activity
   Early  age  at  marriage
   First  pregnancy  before  20  years  of  age
   Multiple  pregnancies  at  short  intervals. (This  leads  to  repeated  injury  to  the  cervix  leaving  it  no  time  to  heal. )
   Sexual promiscuity  i. e.  multiple  male  sexual  partners   or  even  a  single  male  partner  having  sexual  relations  with  multiple  female  partners.
   Poor  genital  hygiene
   Genital  tract  infections  especially  HPV (human  papilloma  virus )  infection.
   Tobacco  addiction

Thetragedyisthatmostofthesefactorsarepreventablebutbecauseofignoranceunhygienicconditionsandlackofawarenessaboutpersonalhealth,cervicalcancerstillaccountsforalargenumberofdeaths.

   Bleeding  ``between  menstrual  periods
   Bleeding  after  sexual  intercourse.
   Bleeding  any  time  after  menopause.
   Irregular  heavy  menstrual  periods.
   Unusual  blood  stained  vaginal  discharge.
   Unexplained  weakness/tiredness/weight loss

Howeveroneshouldrememberthatsimpletestscandetect earlyprecancerouscervicalchanges( Dysplasia )muchbeforethesesignsandsymptomsoccur. THE PAP SMEAR Thetestissimpleandpainless. Usingacottonswaborabrush, cellsfromthecervixarecollectedandspreadoveraglassslideandexaminedunderamicroscope.

   Getting  a  regular  Pap  test  done  if  you  are  above  the  age  of  30  and  have/had  sexual  activity
   Delaying  the  age  of  marriage  so  that  the  age  at  first  sexual  intercourse  also  gets  delayed.
   Postponing  the  birth  of  the  first  child  to  after  20  years  using  contraceptives.
   Avoiding  multiple  and  rapid  pregnancies  through  family  planning.
   Modifying  life-style  patterns  like  discouraging  sexual  intercourse  at  an  early  age, avoiding  intercourse  with  multiple  partners  stopping  tobacco  use.
   Using barrier contraceptives ( e.  g. condoms )  to  prevent  sexually  transmitted  infections.  This  would  also  help  to  space  births.
   Maintaining  good  genital  hygiene   at  all  times  particularly  while  bathing  and  especially  during  your  menstrual  period.  Your partner’s  genital  hygiene  is  also  important.
   Seeking  medical  help  from  either  your  gynecologist  or  family  doctor, if  you  have  any  of  the  above  signs  and  symptoms  at  the  earliest.

EVERYTHING YOU SHOULD KNOW ABOUT RECTAL CANCER WHAT IS RECTAL CANCER? The lower part of the colon that connects the large bowel to the anus is called the rectum. It’s primary function is to store formed stool in preparation for evacuation from the body. The inner surface of the rectal wall is lined with mucosa that composed of glands that secrete mucus to help the passage of stools. It is also surrounded by lymph nodes that are part of the immune system and assist in conducting surveillance for harmful materials (viruses/bacteria etc. ) that may be a threat to the body. Rectal cancer can stem from the mucosa on the inner surface of the rectal wall , or from the rectum to the lymph nodes. The prognosis and treatment of rectal cancer depends on how deeply the cancer has invaded the rectal wall and surrounding lymph node 25% of cancers of large intestine being from the rectum. It is the third most common cancer amongst men, and fourth most common amongst women. WHAT PUTS YOU AT RISK ? Research has been unable to pinpoint specific causes for rectal cancer. It develops over a period of time and the fastest way to detect it is to be alert when the initial complaints are rectal related (piles fissures hemorrhoids etc. ) SOME RISK FACTORS INCLUDE

   A  family  history  of  colon  or  rectal  cancer
   Personal  or  family  history  of  polyps
   High-fat  diet  and/or  a  diet  mostly  from  animal  sources
   Increasing  age
   Smoking

WHAT ARE THE SIGNS AND SYMPTOMS ?

   Slight  bleeding
    
   Alteration  in  bowel  movements
    
   Pencil  thin  stool
    
   Sensation  of  incomplete  defecation
    
   Unexplained  weight  loss

HOW IS RECTAL CANCER DIGNOSED AND TREATED ?

   Fecal  occult  Blood  Test

This determines the presence of blood in the stools

   Digital  Rectal  Examination
    
   Rectal  Endoscopy

Usinganendoscope(aflexibletubewithcameraattheend )adoctorcanseetherectumandcolonthroughtheanusandifrequireddobiopsybytakingasmallpieceofthetumortodeterminemalignancy.

   Colonoscopy,  chest  x-ray  and  scans  of  other  parts  of  the  body

Thetreatmentofrectalcancerisdeterminedbasedonhowfarthetumorhasinvadedtherectalwall ,whetherthelymphnodeshavebeenaffectedandifthetumorhasspreadtootherparts/organsofthebody.Oncethathasbeendetermined yourphysicianwillsuggestoneorcombinationofsurgeryradiotherapyandchemotherapy.

Cancersthatoriginateintheupperrespiratorytract,whichincludestheoralcavity (mouth, lipsandsalivaryglands ),nasalcavity(nose,sinuses )andthroatregion( pharynx,larynx )arereferredtoascancersoftheneck&head.ThesearereferredtoasSquamouscellCarcinomas,indicatingthattheyoriginateinthemucosalliningoftheaffectedparts

   Larynx:  Is also  called  the  voice  box  and  includes  epiglottis, vocal  cords  and  cartilage  below  the  pharynx.
   Pharynx:  Includes  tube  leading  from  nose  to  esophagus,  back  of  mouth,  base  of  tongue  and  tonsils.
   Oral  Cavity:  Includes  lips  gums ,  front  two-thirds  of  tongue, lining  inside  cheeks  and  lips,  floor  of  the  mouth  under  tongue,  the  roof  of  the  mouth (hard  palate ),  area  behind  wisdom  teeth.
   Sinuses  and  Nasal  Cavity:  Hollow  space  inside  and  around  nose 
   Salivary  Glands
   Upper  Throat  Lymph  Nodes

CASUES OFHEADANDNECKCANCER

TobaccoAndAlcohol:Consumptionoftobaccoeitherthroughsmokingorchewingorsnuff.85%ofheadandneckcancersareassociatedwithtobaccoconsumption. Alsoincludedinthislistishighconsumptionofpaanorbetelleaf. Radiation:To the head and neck areas

   Industrial  exposure  to  harmful  elements:  Asbestos  or  inhalation  of  industrial  wood  or  nickel  dust.
   Poor  Oral  Hygiene

   Neck  area: Lump  in  the neck,  neck  pain,  enlarged  lymph  nodes.
   Mouth  area:  Bleeding  or  numbness  from  the  mouth  bad  breath,  sore  tongue  sores  of  mouth  ulcers  that  do  not  heal,  white  red  or  dark  patches  in  the  mouth,  lump  in  the  gums  or  lips,  slurred  speech,  hoarse  voice.
   Nose  area:  prolonged  sinus  congestion,  persistent sore  throat,  difficulty  in  swallowing  and  bleeding.
   Other symptoms:  Includes  earache  or  sudden  weight  loss.

Understandingofsymptoms&microscopicevaluationoftheaffectedregionareimperative.A needlebiopsyisnormallyconductedfirst.YourdoctormayalsosuggestsomeorallofadditionaltestslikeEndoscopy,X-ray,CTscan,MRI,PETscan&Bipsoy

Basedontheseresultsateamcomprisingofanoncosurgeon,dentist , pathologist, oncologist,radiationtherapistwilldeterminethetreatment.This mayincludesurgeryradiation&chemotherapy.

ThethyroidisasmallbutterflyorshieldshapedglandinthefrontofneckjustbelowtheAdam’sapple.Itisknownastheactivityglandbecauseitproducesthetwomainhormonesthyroxin(T4 )&triiodothyronine (T3 ),whichareneededtokeepthebodyfunctioningatitsnormalrate.

CANCEROFTHETHYROID GLAND Cancerofthethyroidisraremaygrowveryslowlyanditmaybesomeyearsbeforeitstartstocauseanyproblems. Todaytheoutlookforpeoplewithcancerofthethyroidisverygood&manypeoplearecompletelycuredofthediseaseevenifithasspreadbeyondthethyroid. There arefourmaintypesofcancerofthethyroid.Byexaminingcellsfromthecanceryourdoctorwillbeabletotellwhichtypeyouhaveandthereforedecidethebesttypeoftreatment.

WHAT CAUSES CANCER OF THE THYROID ? Thecauseofthyroidcancerisunknownhoweverarecognizedriskfactorisradiationexposureandithasbeenfoundinpeoplewhohavehadexternalradiotherapytotheneck10or20yearspreviously, aswellasChernobylchildren.Researchinto thecausesofthyroidcancerisongoing.Veryoccasionallypapillarycancerishereditaryandmedullarcancerisquiteoftenhereditary.

Inmostcasescancerofthethyroidgrowsveryslowly.Thefirstsignisusuallyapainlesslumpintheneckwhichgraduallygetsbigger.Occasionally,athyroidtumor maypressontheoesophagus (gullet )ortrachea ( windpipe )&causedifficultyinswallowingorbreathingItcanalsocauseaHoarsenessofvoice.

IT isunusualforcancerofthethyroidtoaffectthethyroidhormonessosymptomsofhyperthyroidismorhypothyroidismarerare. Ifyounoticealumpinyourneckoranyoftheabovesymptomsyoushould seeyourdoctorassoonaspossible.However,thereareanumberofbenignconditions( suchasagoiter )whichproduceaswellingintheneckandarefarmorecommonthancancer.

Usuallyyoubeginbyseeingyourfamilydoctorwhowillexamineyouandarrangeanytestswhichmaybenecessary. Thesemayincludebloodteststoseeifyourthyroidglandisworkingasitshould.YourGPwillthenreferyoutohospitalforspecialistadvicetestsandtreatment.ImportanttestsincludeBloodtests, Ultrasoundthyroidscan.Thyroid radioisotope scan.Fineneedleaspirationcytology.

Surgery,radioactiveiodineandradiotherapyaregivenaloneorincombitiontotreatcancerofthethyroid. Thyroidcancercanusuallybetreatedverysuccessfullyandmanypatientsare cured.

Becausemanytypesofcancersgrowslowlyand sometimescomeback10ormoreyearsaftertreatmentyourdoctorswillwanttowatchyouforalongtime. Physicalexams,bloodtestsandimagingstudiessuchasCTscansMRIandx-raysmaybedonetowatchforsignsthatthecancerhascomebackorspread.

AnalterationinstructureofDNAcellscausesuncontrolledcellgrowth.Thisresultsintheformationoftissuethatarereferredtoastumors.Lungcancerreferstoanytypeofmalignanttumorthatoriginatesorspreadstotherespiratorysystem. Itisoneofthemostcommonofallcancers.

    Squamous  cell  carcinoma-Begins in  the  bronchi
   Adenocarcinoma-Begins on  the  outer  edges of  the  lung  and  is  most  common  amongst  people  who  have  never  smoked.

SMALL CELL LUNG CANCER: This type of cancer initially responds better to radiation and chemotherapy and is often contracted by smokers. This type of cancer tends to grow rapidly There are two stages: 1 ) Limited: Limited to one lung and/or lymph nodes on the same side of the chest. 2)Extensive/Metastatic: This type has spread to other parts/organs of the body. Cancer that originates elsewhere in the body and spreads to the lungs is referred to as Secondary Lung Cancer. WHAT PUTS YOU AT RISK ?

   Smoking:  Smokers   account  for  over  80%  of  all  lung  cancer  cases.  Those  who  smoke  20  cigarettes  are  20  times  more  likely  to  contract  this  form  of  cancer.
    
   Passive  Smoking:  Non  smokers  who  live  with  smoker  are  27%  more  likely   to  contract  lung  cancer
   Occupational  Exposure:  Those  who  are  constantly  exposed  at  work  to  chemicals  and  substances  that  are  toxic  in  nature  are  at  greater  risk.  Examples  of  these  substances  are  arsenic,  asbestos,  beryllium,  cadmium,  coal  silica  and  nickel  that  are  found  in  industries  like  ship  building,  coke  and  gas, agriculture,  mining,  metal  production,  lorry  and  taxi  driving.

WHAT ARE THE SIGNS SYMPTOMS ? COMMON INITIAL SYMPTOMS

   Persistent  cough
   Breathlessness
   Unexplained  weight  loss
   Chest  pain ( intermittent  not  continuous,  becomes  acute  with  coughing
   Coughing  blood  stained  phlegm  known  as  Haemoptysis.

   Finger clubbing.  Can  be  identified  when  the  ends  of  the  fingers  either  begin  to  look  larger  or  more  curved.
   High  temperature  and  fatigue
   Difficulty  in  swallowing.
   Hoarse  voice
   Swelling  of  the  face

Ifthecancerisoftheanadvancestagetherewillbeadditionalsymptomsbasedon thespreadofthecancer.Themostcommonareasthatthecancerspreadstobeingthebrain,liver,thebonesandlymphglands

IfthepresentingproblemincludesHaemotysisandhoarsevoicethenyoumaybereferreddirectlytoacancercenterfordiagnosisandprognosis. AtthisstageyourdoctormayconsideraCTscan,chestx-rayandbronchoscopy.Ifthepresenceoflungcancerhasbeenestablishedthenfurthertestslikeneedlebiopsy,sputumcatology,mediastinnoscopy,thoracoscopyetc.areruntodeterminehowfarithasspreadandwhatstageitisat.

ORAL CANCERS:

Thecombinationofsmokingorchewingtobaccoandexcessivedrinkingcreatesamuchhigherriskoforalandthroatcancer.Excessive exposureto ultraviolet lightalsocancausedamage.Damagetocellsmaycausetomalfunctionandmutateintocancercells.

Avarityoffactorscanincreasetheriskoforalcancer.These include:

Use of tobacco: Tobacco can damage cells in the lining of the oral cavity and upper throat. Smokers are much more likely to develop oral or upper throat cancers than nonsmokers are About 90% of people who develop these cancers use some form of tobacco. People who use smokeless or chewing tobacco are at even higher risk of cancers of the cheek and inner surface of the lips.
Excessive alcohol consumption: Alcohol also can damage cells inside your mouth and upper throat. Roughly three-fourths of people with oral and upper throat cancers are frequent drinkers of alcohol. The combination of alcohol and tobacco use significantly increases your risk.
Prolonged exposure to ultraviolet light: Too much ultraviolet light can damage the cells on your lips and increase your risk of lip cancer. Almost one in three people with lip cancer have jobs that keep them outdoors for long periods of time.
White patches on the tongue or inside of the cheek ( leukoplakia ): Most of the time leukoplakia is not dangerous. But leukoplakia can be serious as some of the patches may show early signs of cancer and many cancers of the mouth occur in areas in which leukoplakia is adjacent. Leukoplakia may result from a varity of causes including smoking or chewing tobacco products or ill fitting dentures.
Red raised patches inside the mouth (erythroplakia ). Erythroplakia is more likely than leukoplakia to indicate a developing cancer. The majority of these are eventually diagnosed as cancer.
Chronic denture irritation: Irritation caused by dentures does not itself appear to be a factor in oral cancer. However poorly fitting dentures can trap particles of tobacco and alcohol and prolonged exposure to these known risk factors may further increase your risk of oral cancer
Human papillomavirus ( HPV ): HPV is a group of sexually transmitted viruses that have been linked to most cases of cervical cancers More recently HPV has been found to be a factor in about one out of five oral cancers.

   A  sore  on  the  lip  or  in  the  mouth  that  does  not  heal.
   A  lump  on  the  lip  or  in  the  mouth  or  throat.
   A  white  or  red  patch  on  the  gums,  tongue,    or  lining  of  the  mouth.
   Unusual  bleeding ,  pain  or  numbness  in  the  mouth.
   A  sore  throat  that  does  not  go  away  or  a  feeling  that  something  is  caught    in  the  throat.
   Difficulty  or  pain  with  chewing  or  swallowing.
   Swelling  of  the  jaw  that  causes  dentures  to  fit  poorly  or  become   uncomfortable.
   A  change  in  the  voice  ,Pain  in  the  ear

Ifanabnormalareahasbeenfoundintheoralcavityabiopsyistheonlywaytoknowwhetheritiscancer.Usuallythepatientisreferredtoanspecialistwhoremovespartorallofthelumporabnormallookingarea. Stagingtestsandexamshelpthedoctorfindoutwhetherthecancerhasspreadandwhatpartsofthebodyareaffected.Itisalsonecessaryinordertoplanthebesttreatment . Staginggenerallyincludes dentalx-raysandx-raysoftheheadandchest.ThedoctormayalsowantthepatienttohaveaCTscanoraMRI.Thedoctoralsofeelsthelymphnodesinthenecktocheckforswellingorotherchanges.Inmostcasesthepatientwillhaveacompletephysicalexaminationbeforetreatmentbegins.

Doctorsusesurgeryandradiationtherapytotreatoralandthroatcancerintheearlieststages. Forcancerinmoreadvancedstagesdoctorsusesurgerycombinerwithradiationtherapyorradiationtherapycombinedwithchemotherapy.Thetreatmentchosenwilldependonanumberoffactorsincludingyouragegeneralhealththetypeandsizeofthetumorandwhetherithasspreadtonearbyareas. Becausemanytypesofcancersgrowslowlyandsometimescomeback10or moreyearsaftertreatmentyourdoctorswill wanttowatchyouforalongtime.PhysicalexamsandimagingstudiessuchasCTscansMRIandx-raysmaybedonetowatchforsignsthatthecancerhascomebackorspread.

Tobaccoandalcoholarebyfarthemostimportantriskfactorsfororalandthroatcancer. Youcangreatlyreduceyourriskbynotsmokingandlimitingtheamountofalcoholyoudrink.Otherstepsyoucantaketohelppreventoralandthroatcanceroritsprogressioninclude:

   Use  of  well  fitting  dentures
   Limiting  your  exposure  to  sun.
   Checking  your  mouth  and  tongue  periodically.
   Visiting  your  dentist  twice  a  year.
   Aiming  for  at  least  five  servings  of  fruits  and  vegetables  daily.

TELL ME SOMETHING ABOUT CANCER Cancer is a disease of the smallest units in the body cells. There are many different types cells in the body and so many different types of cancer can arise from the different types of cell However unlike normal cells the cancer cells are abnormal and multiply out of control. WHAT ARE CELLS ? NORMAL BODY CELLS The human body is made up from millions of tiny cells. Different parts of the body such as organs bones muscles skin and blood are made up from different specialized cells. All cells have centre called nucleus containing thousands of genes. These genes are like codes which control the different functions of the cells. Certain genes control when the cell should divide and multiply and certain genes even control when the cell should die. Normally our body only makes the right number of cells that are needed. As old cells wear out or become damaged new cells are formed to replace them. Some cells normally multiply quickly. For example you make millions of red blood cells each day as old ones become worn out and are broken down. Some cells do not multiply at all once they are mature for example brain cells

ABNORMAL CELLS However sometimes a cell can become abnormal. This occurs because one or more genes in the cell has become damaged or altered and thus affecting its function. Lots of abnormal cells may then develop from a single original abnormal cell. These cells do not know when to stop multiplying. A group of abnormal cells may then form. If this group of cells gets bigger it becomes a large lump of abnormal cells called a tumor. WHAT ARE TUMOURS ? A tumor is a lump or growth of tissues made up from abnormal cells. Tumors are divided into two types-benign and malignant. BENIGN TUMOURS They are not cancerous and are not usually life threatening. These may form in various parts of the body. Benign tumors usually grow slowly and do not spread or invade other tissues. They often do not harm if they are left alone. However some benign tumors can cause problems. For example some grow quite large and may cause local pressure symptoms look unsightly. Also some benign tumors that arise from cells in hormone glands can make too much hormone which can cause unwanted effects. WHY DO BENIGN TUMOURS NOT SPREAD TO OTHER AREAS ? Cells that make up benign tumors are different to malignant cells. Cell in benign tumors tend to be quite similar to normal cells. They do not invade local tissues . A benign tumor often grows slowly within a capsule or within normal cells which surrounded the tumor. A benign tumor tends to look and feel smooth and regular and have a well defined edge. This is unlike a malignant tumor which may look craggy and irregular and its edges tend to be mixed up with the nearby normal cells and tissue. MALIGNANT TUMOURS ( CANCERS ) Malignant tumors tend to grow quite quickly and invade into nearby tissues and organs which can cause damage. The original site where tumor first develops is called primary tumor. Malignant tumors may also spread to other parts of the body to form secondary tumors (metastases). These secondary tumors may then grow invade and damage nearby tissues and spread again. Note: not all cancers form solid tumours.For example in cancer of the blood cells (leukemia) many abnormal blood cells are made in the bone marrow and circulate in the bloodstream

HOW DO MALIGNANT TUMOURS GROW AND SPREAD ? LOCAL GROWTH AND DAMAGE TO NEARBY TISSUES Malignant cells multiply quickly. However to get large a tumor has to develop a blood supply to obtain oxygen and nourishment for the new and dividing cells. Cancer cells make chemicals that stimulate tiny blood vessels to grow around them which branch off from the existing blood vessels. This ability for cancer cells to stimulate blood vessels to grow is called angiogenesis. Malignant cells have the ability to push through or between normal cells. So as they divide and multiply malignant cells invade and damage the local surrounding tissue. SPREAD TO LYMPH CHANNELS AND LYMPH NODES Some malignant cells may get into local lymph channels. (The body contains a network of lymph channels drains the fluid called lymph which bathes and surrounds the body cells) The lymph channels drain lymph into lymph nodes(sometimes called lymph glands).There are many lymph nodes all over the body. A malignant cell may be carried to a lymph node and there it may become trapped. However it may multiply and develop into tumor. This is why lymph nodes that are near to a tumor may enlarge and contain cancerous cells. SPREAD TO OTHER AREAS OF THE BODY Some malignant cells may get into a local blood vessel(capillary) They may then get carried in the bloodstream to other parts of the body. The cells may then multiply to form secondary tumors (metastases) in one or more parts of the body. These secondary tumors may then grow invade and damage nearby tissues and spread again. TYPES OF CANCER There are more than 100 different types of cancer. Each type is classified by the type of cell the cancer originates from. For example a breast cell a lung cell etc. Each type of cancer generally falls into one of three categories

   Carcinomas  are  cancers  that  arise  from  cells  which  line  a  body  surface,  or  the  lining  of  a  gland.  For  example  the  skin  or  the  lining  of  the  gut ,  mouth,  cervix,  airways  etc.
   Sarcomas  are  cancers  that  arise  from  cells  which  make  up  the  connective  tissues  such  as  bones  or  muscles.  For  example  an  osteosarcoma  is  a  cancer  of  bone  tissue.
   Leukaemias  and  lymphomas  are  cancers  of  cells  in  bone  marrow  and  lymph  glands.  For  example,  leukemia  is  a  cancer  of  cells  that  make  white  blood  cells.

Somearemoreeasytotreatthanothers,particularly ifdiagnosedatanearlierstage

Some haveabetteroutlook(prognosis)thanothers.Forsometypesofcancerthereisagoodchanceofbeingcured.Forsometypesofcancertheoutlookispoor.

The major salivary glands are the:

   Sublingual  glands  found  underneath  the  tongue
   Parotid  glands  at  the  sides  of  the  mouth  just  in  front  of  the  ears
   Submandibular glands under the jawbone.

Therearealso manymoretinyglandsintheliningofthemouthandthroat.Thesedonothaveindividualnamesbutareknownastheminorsalivaryglands

Therearemanydifferentcelltypes.Salivaryglandcancersarealsogivenagradeof1,2or3basedonhowtheylookunderamicroscope.Grade1(alsocalledlow-grade)cancercellslookmorelikenormalcellsandhaveabetteroutlook.Grade3(highgrade)lookverydifferentfromnormalcellsandarelikelytogrowandspreadmorequickly.Grade 2 cancersareinbetween.

Radiation:Radiationtreatmenttotheheadandneckareaorworkexposuretocertainradioactive substancescanincreasetheriskofthiscancer

Work:Somestudiessuggestthatworkingwithcertainproductssuchasnickelalloydustorsilicadustmayincreasetheriskofthiscancer.Other studiesdidnotshowalink

Salivaryglandcancerisoftenpainlessinitsearlystages.Themostcommonsignisalump,massorswellingintheareaofsalivarygland.Justbecauseyouhavealumpintheareaofsalivarygland,howeverdoesnotnecessarily meanyouhavecancer.Morethanhalfthetumorsfoundinthesalivaryglandsarenon-cancerous.Other symptoms include:

   Numbness  in  part  of  your  face
   Muscle  weakness  on  one  side  of  your  face
   Persistent  pain  in  the  area  of  salivary  gland

Ifthereisanyreasontosuspectsalivaryglandcancer,thedoctorwilluseoneormoremethodstofindoutifthediseaseisreallypresent.The doctoratthehospitalwilltakeyourfullmedicalhistory,carryoutaphysicalexamination,andtakebloodsamplestocheckyourgeneralcondition.ThefollowingtestsarecommonlyusedtomakediagnosissuchasX-rays,CTscanMRIscanandBiopsy.

Salivaryglandcancerscanstartinvariouscellswithinthesalivaryglandsandmaybesloworfastgrowing.Yourtreatmentplanshouldbetailoredspecificallyforyoubyateamofdoctorsincludingsurgeons, cancerspecialistsanddoctorswhospecializeintreatingcancerwithradiation.Thetypeoftreatmentgivenwilldependonnumber ofthingsincludingthepositionofthecancertheexacttypeofcancerandyourgeneralhealth The3maintypesoftreatmentforthesecancersaresurgery,radiationandlessoftenchemotherapy. Sometimes2ormoreofthesemethodsareusedtogether. Becausemanytypesofcancersgrowslowlyandsometimescomeback10ormoreyearsaftertreatment, yourdoctorwillwanttowatchyouforalongtime.PhysicalexamsandimagingstudiessuchasCTscanMRIandx-raysmaybedonetowatchforsignsthatthecancerhascomebackorspread.

   Avoidance of tobacco  use.
   Avoidance or limiting  exposure  to  radiation  when  possible.
   Checking  your  mouth  and  jaw  periodically  for  lumps  or  bumps.
   Having  your  doctor  or  dentist  check  your  salivary  glands  during  routine  checkups.

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   CANCER

WHAT IS CANCER ?

Therearemanydifferenttypesofcellsinthebodyandsomanydifferenttypesofcancerscanarisefromthedifferenttypesofcells.However,unlikenormalcells ,thecancercellsareabnormal&multiplyoutofcontrol. KNOW ABOUT BREAST CANCER To promote awareness on breast cancer encourage early detection and prompt treatment . RISK FACTORS Following are The factors make a woman more prone to get breast cancer. We really can’t prevent breast cancer but what we can do is to detect it early. Early detection saves lives and lowers treatment costs.

    Increasing  age
   A  family  history  of  breast  cancer  especially  if  a  first  degree  relative  (mother  sister  aunt  )  had/has  breast  cancer.
   A  past  history  of  breast  cancer  in  the  other  breast  or  fibrocystic  breast  disease  (an  exaggerated  lumpy  painful  condition  related  to  the  menstrual  cycle.)
   Early  age  of  menarche  ( first  period )
   First pregnancy after 30 years.
   Having no children.
   Women who  have  not  breast  fed  their  children.
   Late  menopause (cessation of periods).
   Dietary  factors  like  consumption  of  alcohol,  drinks/weak  diet,  rich  in  animal  fat  and  obesity.

SIGNS AND SYMPTOMS

A lump or thickening within the breast or armpit.
A discharge from the nipple.
Adiscolourationorchangeinthetextureoftheskinoverlyingthebreast (dimpling/puckering/scaling )

WAYS TO DETECT BREAST CANCER Asmorebreastcancersaredetectedearlyfarfewerwomenwilllosetheirlivesanditispossibletotreatbreastcancerintheearlystageswithpreservationofthebreast. Fortunatelytherearewaysbywhichyoucandetecttheearlyonsetofbreastcancer Breast Self Examination (BSE )This is a simple technique by which every woman above 18-20 years can notice certain changes in her breast which may be suggestive of breast cancer. Ideally it should be performed once a month (preferably a week or so after her periods ) If she has stopped getting periods the examination must be done every month on a fixed day. It should be done in the privacy of her bedroom or whilst bathing when the soapy feel of the body makes it convenient for examination. What follows are instructions and illustrations to help you learn to do BSE.

   Look  at  your  breasts  in  a  mirror.  Look  for  any  changes  in  size  or  shape , retraction  of  nipple  dimpling  or  thickening  of  skin  or  any  obvious  lump.
   Raising  both  your  arms  look  for  any  unevenness  in  your  breasts
   Keep  your  around  your  waist  and  press  them    firmly.  These  positions  may  help  in  showing  any  retraction  or  dimpling  present  over  the  skin  of  the  breast
   Feel  the  whole  breast  in  a  systematic  manner. The  breast  is  divided  into  5  parts.  The  upper  inner  area , upper  outer  area,  lower  inner  area ,lower  outer  area  and  the  central  area  beneath  the   nipple.  Feel  all  the  parts  of  the  breast  without  missing  any  area.
   Lay  down  with  one  of  your  arm  stretched  .  Keeping  your  fingers  close  to  each  other  use  the  flat  surface  of  your  fingers  to  feel  for  any  lump  in  the  breast  Do  not  feel  the  breast  between  the  finger  tips  and  the  thumb.  Press firmly enough to know how  your  breast  feels.  A  firm  ridge  at  your  lower  curve  of  each  breast  is  normal.
    
    
   A  clinical  breast  examination  by  the  doctor

Aspartofyourphysicalcheck-upwithyourgynecologist makesureyourdoctorexaminesyourbreastsatleastonceayearifyoufallwithinoneoftheaboveriskgroups.

   A  mammogram

Thisisessentiallyanx-rayofthebreast. Itisusedonlyforwomenwhofallwithinthehigh-riskgroupandisthereforenotadvocatedforroutineuse.

   If  a  lump  is  present  a  biopsy  may  be  required.

CervicalcancerthemostcommoncanceramongIndianwomen. It isadiseaseinwhichcanceraffectstissuesofthecervixi.e. themouthoropeningofuterus (womb ).125000womenareaffectedeachyearneedlesslyclaiminganestimated50,000lives .Our aimistoalertyouaboutthepreventionandearlydetectionofcervicalcancer.

   Early  onset  of  sexual  activity
   Early  age  at  marriage
   First  pregnancy  before  20  years  of  age
   Multiple  pregnancies  at  short  intervals. (This  leads  to  repeated  injury  to  the  cervix  leaving  it  no  time  to  heal. )
   Sexual promiscuity  i. e.  multiple  male  sexual  partners   or  even  a  single  male  partner  having  sexual  relations  with  multiple  female  partners.
   Poor  genital  hygiene
   Genital  tract  infections  especially  HPV (human  papilloma  virus )  infection.
   Tobacco  addiction

Thetragedyisthatmostofthesefactorsarepreventablebutbecauseofignoranceunhygienicconditionsandlackofawarenessaboutpersonalhealth,cervicalcancerstillaccountsforalargenumberofdeaths.

   Bleeding  ``between  menstrual  periods
   Bleeding  after  sexual  intercourse.
   Bleeding  any  time  after  menopause.
   Irregular  heavy  menstrual  periods.
   Unusual  blood  stained  vaginal  discharge.
   Unexplained  weakness/tiredness/weight loss

Howeveroneshouldrememberthatsimpletestscandetect earlyprecancerouscervicalchanges( Dysplasia )muchbeforethesesignsandsymptomsoccur. THE PAP SMEAR Thetestissimpleandpainless. Usingacottonswaborabrush, cellsfromthecervixarecollectedandspreadoveraglassslideandexaminedunderamicroscope.

   Getting  a  regular  Pap  test  done  if  you  are  above  the  age  of  30  and  have/had  sexual  activity
   Delaying  the  age  of  marriage  so  that  the  age  at  first  sexual  intercourse  also  gets  delayed.
   Postponing  the  birth  of  the  first  child  to  after  20  years  using  contraceptives.
   Avoiding  multiple  and  rapid  pregnancies  through  family  planning.
   Modifying  life-style  patterns  like  discouraging  sexual  intercourse  at  an  early  age, avoiding  intercourse  with  multiple  partners  stopping  tobacco  use.
   Using barrier contraceptives ( e.  g. condoms )  to  prevent  sexually  transmitted  infections.  This  would  also  help  to  space  births.
   Maintaining  good  genital  hygiene   at  all  times  particularly  while  bathing  and  especially  during  your  menstrual  period.  Your partner’s  genital  hygiene  is  also  important.
   Seeking  medical  help  from  either  your  gynecologist  or  family  doctor, if  you  have  any  of  the  above  signs  and  symptoms  at  the  earliest.

EVERYTHING YOU SHOULD KNOW ABOUT RECTAL CANCER WHAT IS RECTAL CANCER? The lower part of the colon that connects the large bowel to the anus is called the rectum. It’s primary function is to store formed stool in preparation for evacuation from the body. The inner surface of the rectal wall is lined with mucosa that composed of glands that secrete mucus to help the passage of stools. It is also surrounded by lymph nodes that are part of the immune system and assist in conducting surveillance for harmful materials (viruses/bacteria etc. ) that may be a threat to the body. Rectal cancer can stem from the mucosa on the inner surface of the rectal wall , or from the rectum to the lymph nodes. The prognosis and treatment of rectal cancer depends on how deeply the cancer has invaded the rectal wall and surrounding lymph node 25% of cancers of large intestine being from the rectum. It is the third most common cancer amongst men, and fourth most common amongst women. WHAT PUTS YOU AT RISK ? Research has been unable to pinpoint specific causes for rectal cancer. It develops over a period of time and the fastest way to detect it is to be alert when the initial complaints are rectal related (piles fissures hemorrhoids etc. ) SOME RISK FACTORS INCLUDE

   A  family  history  of  colon  or  rectal  cancer
   Personal  or  family  history  of  polyps
   High-fat  diet  and/or  a  diet  mostly  from  animal  sources
   Increasing  age
   Smoking

WHAT ARE THE SIGNS AND SYMPTOMS ?

   Slight  bleeding
    
   Alteration  in  bowel  movements
    
   Pencil  thin  stool
    
   Sensation  of  incomplete  defecation
    
   Unexplained  weight  loss

HOW IS RECTAL CANCER DIGNOSED AND TREATED ?

   Fecal  occult  Blood  Test

This determines the presence of blood in the stools

   Digital  Rectal  Examination
    
   Rectal  Endoscopy

Usinganendoscope(aflexibletubewithcameraattheend )adoctorcanseetherectumandcolonthroughtheanusandifrequireddobiopsybytakingasmallpieceofthetumortodeterminemalignancy.

   Colonoscopy,  chest  x-ray  and  scans  of  other  parts  of  the  body

Thetreatmentofrectalcancerisdeterminedbasedonhowfarthetumorhasinvadedtherectalwall ,whetherthelymphnodeshavebeenaffectedandifthetumorhasspreadtootherparts/organsofthebody.Oncethathasbeendetermined yourphysicianwillsuggestoneorcombinationofsurgeryradiotherapyandchemotherapy.

Cancersthatoriginateintheupperrespiratorytract,whichincludestheoralcavity (mouth, lipsandsalivaryglands ),nasalcavity(nose,sinuses )andthroatregion( pharynx,larynx )arereferredtoascancersoftheneck&head.ThesearereferredtoasSquamouscellCarcinomas,indicatingthattheyoriginateinthemucosalliningoftheaffectedparts

   Larynx:  Is also  called  the  voice  box  and  includes  epiglottis, vocal  cords  and  cartilage  below  the  pharynx.
   Pharynx:  Includes  tube  leading  from  nose  to  esophagus,  back  of  mouth,  base  of  tongue  and  tonsils.
   Oral  Cavity:  Includes  lips  gums ,  front  two-thirds  of  tongue, lining  inside  cheeks  and  lips,  floor  of  the  mouth  under  tongue,  the  roof  of  the  mouth (hard  palate ),  area  behind  wisdom  teeth.
   Sinuses  and  Nasal  Cavity:  Hollow  space  inside  and  around  nose 
   Salivary  Glands
   Upper  Throat  Lymph  Nodes

CASUES OFHEADANDNECKCANCER

TobaccoAndAlcohol:Consumptionoftobaccoeitherthroughsmokingorchewingorsnuff.85%ofheadandneckcancersareassociatedwithtobaccoconsumption. Alsoincludedinthislistishighconsumptionofpaanorbetelleaf. Radiation:To the head and neck areas

   Industrial  exposure  to  harmful  elements:  Asbestos  or  inhalation  of  industrial  wood  or  nickel  dust.
   Poor  Oral  Hygiene

   Neck  area: Lump  in  the neck,  neck  pain,  enlarged  lymph  nodes.
   Mouth  area:  Bleeding  or  numbness  from  the  mouth  bad  breath,  sore  tongue  sores  of  mouth  ulcers  that  do  not  heal,  white  red  or  dark  patches  in  the  mouth,  lump  in  the  gums  or  lips,  slurred  speech,  hoarse  voice.
   Nose  area:  prolonged  sinus  congestion,  persistent sore  throat,  difficulty  in  swallowing  and  bleeding.
   Other symptoms:  Includes  earache  or  sudden  weight  loss.